I’ve been critical of what has become the norm for workplace wellness practices for some time now. But I am no more anti-workplace wellness than I am anti-children, anti-puppies, or anti-Mother Nature. How could anyone be anti-wellness?
What many people in workplace wellness are starting to become is anti-clueless and pro-common sense. Think of it as a much-needed renaissance for our field in the area of critical thinking.
The Bernie Madoff School of Workplace Wellness ROI
It was inevitable. For years, fantastical reports of huge, positive ROI on wellness programs flooded the profession of wellness and the business media. I’ve always had a hard time believing these reports, just like I have a hard time believing people like Madoff (now in prison) who claim to produce magnificent and consistent financial returns with no downside risk, regardless of the health of the economy. There is always something wrong with that kind of picture. (See my article, “Workplace Wellness ROI: A Simple Way to Verify.”)
The recently released Rand Report data is at the epicenter of more people questioning the effectiveness of wellness programs to reduce healthcare costs. The report is comprehensive and nuanced. But, the media jumped on the fact that some of the big workplace wellness programs as they relate to behavior change have not cut healthcare costs. The headlines spinning from the Rand Report run along the lines of “Does Wellness Work?,” “Wellness Programs Don’t Cut Healthcare Costs,” etc. And the knee-jerk reaction is that this is an “anti-wellness” message that will decimate the budgets of workplace wellness across the land.
Not to worry. Workplace wellness will not go away; it’s just going to change. A lot. And for the better.
Here’s the Current Wellness Model
The problem is wellness has morphed into a narrow clinical function with the objective of cutting healthcare costs. The workplace wellness program model is currently geared to identify health risk via on-site biometric screenings and health-risk appraisals (using incentives). Then, once risk is identified, intervene with coaches, tailored messages, and clinical interventions to get high-risk people into a lower-risk profile. The concept: If you can reduce health risk in a workplace community, the associated costs of avoiding those diseases also goes down. That makes sense to most of us. It just seems natural that healthcare costs would go down if we removed the risk that causes illness.
Note: A big problem with a “risk reduction/cost reduction” model is that the metric is defensive, it cannot be scaled to the upside, and therefore the model can’t contribute to the dynamic growth metrics of the organization. That’s why wellness programs are top candidates for being cut when budgets get tight.
Here are seven things that happened with the risk-oriented workplace wellness model:
1. Low participation was (and is) the experience in risk-screening events at workplaces.
2. Incentives to engage people (get them to sign-up) ate up or outstripped the actual cost of the entire wellness programs.
3. The clinical nature of the screenings made confidentiality an issue.
4. The wellness programs became complex and needlessly expensive.
5. Some massive health screening actually resulted in over diagnosis and over treatment, thus increasing costs.
6. Cancers, heart disease, and other expensive-to-treat ailments continue to occur in the workplace as they do in the general population. The benefits of healthful living can always improve a person’s life, but can’t always reverse a lifetime of poor lifestyle habits. If you have 1,000 employees, a good health statistician can probably accurately predict your incidence of serious and expensive diseases for the next couple years – wellness program or not.
7. Although some cost savings and behavior change are observed in the short term, many positive outcomes can’t be claimed for the long term. Workplace weight-loss programs (now very popular) are an obvious example. Listen to the Webinar “Health For Every Body” with Jon Robison on HPLive. (If you don’t have a password to HPLive, you’ll have to register, but it’s well worth it. HPLive.org hosts the best free Webinars in wellness, and entertains all viewpoints.)
Somewhere along the line, in about the mid-1990s (when HRAs started being used by workplaces on a mass basis) wellness went all in on risk reduction. It turned its back on the importance of the cultural, social, and holistic components of healthful living. As a result, wellness became a clinical exercise with a secondary prevention center of gravity. I cover more of this issue in my new eBook, “Six Questions That Make Creativity More Valuable Than $$$ When Planning Your Wellness Program.”
2014 will be a Year of Workplace Wellness Taking a Beating in the Media
This coming year, you’ll be hearing much more about the failure of wellness to control or reduce healthcare costs. But as Dr. Rosie Ward so aptly puts it her LinkedIn discussion group, Sustainable Organizational Well-Being, wellness has become too narrow. It’s not that wellness does not work; the issue is we haven’t really employed strategies and tactics that include all of the psycho-social aspects of being human. The goal of reducing health risks and health costs should never have been our objective as wellness professionals.
Where Does Workplace Wellness Go From Here?
In my recent article “What’s The True Value of Workplace Wellness?,” you’ll discover I think productivity via superior recruitment and retention of talented people will be the new metric. For that to happen, the entire culture of an organization needs to be healthy.
And I don’t mean cafeteria menu changes or activity-related competitions when I talk about culture. I mean our workplace cultures have to change at the core competency level of the workplace. Better bosses, common-sense rules, clear communication, creative risk-taking, and celebrating achievement. Simple stuff that is hard to do.
Once the culture improves, wellness will be more event-oriented and tied much tighter into the community. It will also make a strong move into being more about primary prevention (lifestyles) instead of secondary prevention (screening and intervention). And it will be more holistic. A first step in that direction is to realize the way we currently manage work is creating a lot of the stress and anxiety we want to eliminate. People have to like their jobs if they’re going to be healthy.
Here are Five Predictions for the Future of Wellness
1. Wellness program ideas will move from defense to offense. The metrics will be more tied into HR because wellness will be about the kind of people you want to recruit, support, and prepare as future leaders. We’ll think about the concept of healthy people working in healthy workplaces. Wellness will become scalable. If a pilot program works, it’s likely the same program will work on a bigger basis.
2. Programs will be tied tightly to the community, often be multi-generational, and employees will rightly take great pride in those programs.
3. Wellness vendors and coaches will become much more affordable and will result in a bigger market as more workplaces seek their help. Your workplace is more likely to be part of a community cooperative of workplaces that share resources, ideas, expertise, and a common lifestyle vision for where you live.
4. Wellness may be called something else. Well-being is a possibility. It’s not uncommon to change lexicons, and seek new references to distance ourselves from outdated thinking. As you hear new ways to explain the changes occurring in the wellness environment, that should be a healthy sign.
5. Disease management and wellness will not be so co-mingled. Disease is part of life, and thus tied to our holistic concept of wellness. But disease management will help people who are designated as “patients” for a specific ailment. Hopefully, we will move away from identifying everyone as a patient, and think of each individual more as a productive person.
Workplace wellness will cease to exist as it does now. Its best days are not behind us. They’re on the horizon.
Shawn is the President and Founder of Hope Health. For over 30 years, his work has focused on bringing clear, easy-to-read and watch health messages to the public via workplaces. He bills himself as the “Best C+ Student in the Wellness Biz” because, as he says, “I like to challenge the notion that there is no such thing as a stupid question.” Shawn is on a mission to tie workplaces into their surrounding communities to share resources and ideas in an effort to improve the health of all Americans.
You may reach Shawn at sconnors@HopeHealth.com or 800-334-4094.